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Fallopian tubes

Apr 15, 2012 , Vladislava Králová

The Fallopian tubes are hollow tubes connecting the uterus and the ovaries. It is usually where an egg is fertilized by a male reproductive cell, sperm. The resulting embryo then travels through the tube towards the uterus, where it develops and grows. Diseases of the Fallopian tubes, if not treated properly and on time, tend to be a cause of infertility in women, and in case of the rare Fallopian cancer, a potential cause of death.

Fallopian tubes

Together with the ovaries and the uterus, fallopian tubes are one of the female internal reproductive organs. It is a pair organ, located on both sides of the uterus in the pelvis. The fallopian tubes form the connection between the ovaries and the uterus and represent the way the mature egg travels through after ovulation, the expelling of a matured egg from the ovary at the end of the ovulation cycle. The fallopian tubes is also where the get is fertilized by a sperm. This means that it is impossible to get pregnant in the normal way without fallopian tubes.

Anatomy of fallopian tubes

The fallopian tubes start in the upper part of the uterus in its corner. From there they widen funnel-like and open freely into the abdominal cavity near the ovaries. Their length is anywhere between 10-15 cm, their width is 0,5 cm on the average, although it is only a single millimeter in the uterus's corner. We discern three parts of the fallopian tube, the funnel part, the wider part and the tapered part. The funnel is the part opening near the ovaries. Its edge is lined with cilia. During ovulation the funnel places itself on the surface of the ovary in the part where the egg will be expelled. After being released, the egg is caught in the funnel and passes down through the tube. Fertilization occurs in the wider part of the tube, which is known as ampulla. The tapered part connects to the uterus' wall. The organ itself is muscular. The musculature is smooth, therefore not controllable by will. The inner mucous layer is folded into numerous folds and contains two basic types of cells.

Ciliated cells

Each type of these cells has its particular function. One type are the ciliated cells. Their name comes from the fine cilia the cells have on their surface. The cilia are constantly oscillate towards the uterus and move the eggs in that direction. The slow, rhythmical contractions of the fallopian tube's muscles also help move the egg.

Secretory cells

The second cell type are the secretory cells. These cells secrete nutritious substances. These nourish the released egg, whether it is fertilized or not. These substances also help change the sperm to allow it to fertilize the egg. This is called capacitation. After this change the sperm is moving faster, is capable of seeking out the egg and bind itself to its surface.

Fallopian tube diseases

The fallopian tubes can be afflicted by a range of diseases, which, if untreated, can lead to adhesions, blockages and infertility as a result.

Blockage of fallopian tubes

The most common and simultaneously the most serious disorder in the fallopian tube area is their partial or complete blockage. The blockage occurs based on adhesions, which are a result of an inflammation being treated insufficiently or too late. They can cause infertility, with the egg being unable to enter the uterus. The fault can also be in the insufficiency of cilliary cells, which then don't move the egg towards the uterus. The egg is then absorbed in the fallopian tube, which can be painful for the woman.

Extrauterine pregnancy

Another serious complication which can occur due to blockage of the fallopian tubes or the presence of endometriosis is an extrauterine pregnancy. During this pregnancy the fertilized egg develops generally right in the blocked or otherwise changed fallopian tube. This poses a great risk if the pregnancy continues for a longer period and the fetus reaches a bigger size. The walls of the fallopian tubes may not withstand the pressure and may rupture. This causes serious bleeding into the abdominal cavity, which can even lead to death.

Endometriosis

Endometriosis is a disorder where the uterine mucosa, the endometrium, is founds outside the uterus, most commonly on the ovaries, the fallopian tubes and the urinary bladder. This mucosa, much like the one in the uterus is under the effect of female sex hormones and changes during menstruation, which causes minor bleeding in the afflicted area, which manifests as a long-lasting pain in the abdomen, growing worse during menstruation. Small cavities and scars eventually form around the areas with endometriosis, leading to adhesions, which in the case of endometriosis lead to infertility in up to 50% of cases.

Fallopian tube inflammation

An inflammation of the fallopian tubes happens due to a vaginal infection, during which the bacteria are spreading into the uterus, the fallopian tubes and the ovaries. Together this is referred to as a pelvic inflammatory disease. The cause of this disease are usually bacteria transmitted by sexual intercourse. Fallopian tube inflammation can be also caused by an infection of the appendix or the large intestine though. The symptoms of the inflammation vary depending on the scale of the disease. We discern an acute or chronic inflammation. Acute inflammatory disease manifests by suddenly appearing abdominal pain, fever, vomiting, nausea, constipation or diarrhea, painful urination and bleeding outside of menstruation. Purulent discharge from the vagina may also be present. Chronic inflammation manifests by back pain in the lumbar and sacral area, constipation, flatulence, irregular menstruation and infertility. The treatment mainly involves antibiotics. If the treatment is unsuccessful, a surgical intervention is needed. Any pus and adhesions are removed surgically from the fallopian tubes. If the fallopian tube inflammation and the pelvic inflammatory disease in general are treated insufficiently or untreated, the risk of permanent infertility increases. The above mentioned extrauterine pregnancy can also occur dues to adhesions.

Fallopian tube cancer

Cancer of the fallopian tubes is luckily a rare disease, whose peak of occurrence is usually given as the 50th year of life. Due to the cancer developing on an organ located freely in the abdominal cavity, the cancer is symptomless for a long time. This means the cancer is often diagnosed in an advanced stage. The advanced fallopian tube cancer has a tendency of afflicting nearby organs or spreading into more remote parts of the body. The symptoms, as has already been said, only appear in cases, where the tumor causes issues due to its size or afflicting other organs, issues such as indigestion, increasing stomach volume feeling of pressure a weight in stomach and occasionally through suddenly appearing strong pain or nausea. The treatment usually involves surgical removal of the tumor and chemotherapy, aggressive anticancer drugs.

Tubal ligation

One of possible contraception methods is a tubal ligation. This is a mechanical blockage of the tube done as a small surgical procedure. Tubal ligation is a highly effective and definitive method. If the woman wants to become pregnant afterward, this is still possible. The fertilized egg needs to be inserted into the uterus by a doctor, however.

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